In Street Vendors' Smorgasbord, Threat of Sickness Lurks

They are a colorful part of New York's cityscape -- street corner food vendors, with their tilting umbrellas and curbside cookeries. These days, they deliver a sidewalk smorgasbord as varied as the city itself -- the traditional hot dogs and pretzels, along with hamburgers, chicken, pork, lamb, duck, even fish and tripe.

But with their diverse fare, many vendors are serving up a heightened risk of sickness, according to safety experts, city health records and tests of sidewalk food.

The familiar stainless-steel carts are small and lack basic kitchen equipment, yet roughly 40 percent of New York's vendors handle foods that can be hazardous, according to city figures. Many show up in the morning with tubs of raw meat and poultry, which can carry disease-causing bacteria. Food is often left unchilled and unheated, ideal for the growth of E. coli, salmonella and other germs. And some vendors wash their hands so seldom that they use their sinks for storage space.

Tests arranged by The New York Times on a random sampling of chicken, burgers and kebabs from vendors' carts showed significant undercooking in 39 of 51 cases -- meaning that bacteria would not be eliminated. Experts say it is a potentially dangerous combination: risky fare, poor facilities and unsafe handling.

And even though New York has more food carts than anywhere else in America, many of its regulations are far more lax than in other big cities. Most other cities, for example, have strict limits on what vendors can sell; New York allows anything but shellfish.

Inspections of the 4,100 licensed pushcarts in New York are spotty. Vendors without permits, safety training or water -- all required by city rules -- are allowed to stay on the street.

Even chronic health violators continue to sell food, according to The Times's review of 2,700 city inspection reports from 1996 and 1997. Moreover, weeks and months have often passed before inspectors have investigated pushcarts blamed for illness, those reports show.

And while the city requires vendors with more elaborate menus to take a food-safety course, it is broadly geared for all food-service workers, and vendors get no specific advice about how to manage the peculiar hazards of cooking and serving food in the street.

City health officials defend their efforts to police the trade, and they and vendors themselves insist that the food is generally safe. ''We hold the carts to very high standards, and our inspections are tough to pass,'' said Maryann Lienhard, an assistant health commissioner in charge of inspections.

There are no precise statistics on how many pushcart customers suffer food poisoning -- which most often results in a day or two of vomiting or diarrhea -- and the city says no cases of severe illness have been linked to sidewalk vendors. But doctors and other experts say the risks are clear.

Dr. Michael P. Lucchesi, chief of the city's busiest emergency room, at Kings County Hospital Center, said tainted food was implicated in many of 2,715 cases of gastroenteritis there in 1997. In some of those cases, food from street carts was suspected, though doctors almost never do the tests to confirm the origin of such an illness.

A 1995 City Council survey of 401 New York pedestrians found that 1 out of 10 said they had become ill after eating from a cart.

''When you look at the conditions on these carts and you have patients coming in, complaining about them,'' Dr. Lucchesi said, ''it strongly suggests there is a problem.''

Of 610 food-cart operators whose inspection records were reviewed, half had at least one critical violation in 1996 and 1997. Some lacked permits or could not show they had undergone required safety training; some had no provisions for hand washing or touched ready-to-eat food with bare hands; some left foods out at temperatures ideal for the growth of hazardous bacteria.

Safety questions about street vendors come as consumers across the country are buffeted by warnings about a widening array of hazards in food -- including such seemingly benign sources as fresh apple juice, imported raspberries and lettuce.

Experts note that the potential risks of sidewalk fare are far fewer among those vendors who sell bagels, packaged goods, produce and precooked hot dogs -- in all, about 60 percent. And no doubt many of New York's street vendors are conscientious.

Andrew Ramrattan, who cooks chicken, vegetables, whiting and falafel for as many as 500 people a day at the northeast corner of 43d Street and Avenue of the Americas, said that if some vendors created problems, they did not represent the whole industry.

Eating a steaming plate of his own curried chicken, Mr. Ramrattan, 21, poked his fork at the tiny bits of food. ''We chop it up like this,'' he said, ''so all the chicken cooks real good.'' The only complaints he ever gets, he said, are about long lines at his cart.

But Ryan Halpner, 22, had a different view of the food-cart industry one day when he decided to pick up a lamb shish kebab for lunch from another cart, near Rockefeller Center. Later, his stomach churned, his face flushed and he rushed to the restroom, deeply regretting his choice.

''Either it wasn't cooked fully or something was wrong with it,'' he said. ''My guess is the meat wasn't fresh. It was right when I ate it, but it wasn't right afterward.''

It is lunch hour in the financial district and there are long lines at the food carts. But as people await their burgers and cheese steaks, leftovers from breakfast lie in a carton on the ground near one cart: 30 dozen eggs sitting in the afternoon sun, not yet returned to a refrigerator.

At lunch in Chinatown, a street vendor uses bare hands to slice and scoop pork ribs and roast duck, dripping with grease. Briskly he rubs a rag, counts money, dishes up meat again -- all without soap and water.

When lunch is over in midtown, vendors on the Avenue of the Americas still serve the occasional straggler. But shelves above their grills are heaped with unheated food -- sausage, chicken, gyros, shish kebab -- waiting to be reheated and sold. ''Once it's cooked like this, nothing is going to happen,'' said Naser Abdelhlim, a vendor for eight years, defending his unheated chicken.

But experts say his view, though widely shared, is risky. Bacteria can multiply whenever food -- whether raw, partially cooked or fully done -- sits out at temperatures between 45 and 140 degrees.

City inspectors often find food at such temperatures -- pork sausage at 98 degrees and gyro meat at 105 degrees, to name but a few violations listed in city reports. Further, some vendors cook foods like chicken or sausage only partially, then leave them to sit until a customer orders.

And the final stages of cooking are often inadequate to kill off bacteria that may be present, said Dr. Robert Gravani, a food scientist at Cornell University who tested street fare at the request of The Times.

Choosing carts at random over two days, Dr. Gravani ordered food, watched its preparation, paid for it and immediately tested it with a digital thermometer. Only 12 of 51 items were hot enough to be safe, he found. ''If there was a problem with any of these foods, these temperatures are not going to take care of it,'' he said.

Of 8 hamburgers tested, just 1 was fully cooked. Of 11 chicken dishes, 2 met health standards. Of 5 beef kebabs tested, none measured up. ''This is a clearly risky situation,'' he said. In his travels, Dr. Gravani did not once see vendors wash their hands or utensils. Rather, many sinks were bone dry and inaccessible.

Those observations mirrored a study in 1995 by the City Council's Office of Oversight and Investigation, in which surveillance of 254 vendors for up to 20 minutes each found that none washed their hands.

Near Radio City Music Hall, for example, Dr. Gravani ordered a well-done hamburger, then watched, warily, as the vendor picked up a half-thawed patty with his bare hands, tossed it on his grill -- and used the same unwashed hands to open the bun it was served in. A nearby test showed the patty was still raw inside and 131 degrees instead of the 155 degrees needed to kill E. coli, were it present. ''I wouldn't let my children eat that,'' he warned.

More than any one safety lapse, a combination of failures most worries experts like Bert Bartleson, a state health official in Olympia, Wash., who investigated the 1993 Jack in the Box outbreak in which four children died and more than 500 people became ill from eating undercooked hamburgers tainted by E. coli.

''If you don't have refrigeration and temperature control and you don't have hand washing,'' he said, ''you're asking for an outbreak.''

The Business

Change in Industry Heightens the Risk

The sidewalk food vendor is an emblem of New York -- part of the city's street culture, an attraction for tourists, an aromatic staple of easy lunching.

''Some of my best memories from childhood are of my parents bringing me to Rockefeller Center and buying me a hot dog or a pretzel,'' recalled Howard Eisen, who works at a Wall Street trading firm and was buying a frankfurter in the neighborhood.

For all its tradition, however, street vending has changed markedly in recent years. Especially since the mid-1980's, vendors have expanded their menus, in search of better profits or a niche in the market and sometimes reflecting their ethnic heritage. Now the range of food surprises even some New Yorkers: curried chicken with rice, lamb souvlaki, beef burritos, bratwurst, stewed tripe, Spanish pork chops, cod and beans, vegetable lo mein.

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Another change has come in the industry's structure. Until two years ago, companies with multiple carts controlled 48 percent of the city's 4,100 permits, a total that is limited by the city. Then, in the name of equal opportunity, the city restricted permits to one per person. Companies had to give up their fleets of carts, and they contend that street food is less reliable in an era of newcomers who are harder to track.

Under the best of circumstances, sidewalk food preparation is a difficult and unpredictable undertaking. Sinks run out of water; stoves run out of propane; Sterno flames out; ice melts in coolers. Space is limited, restrooms and refrigerators nonexistent.

For those reasons, 8 of 10 major cities surveyed by The Times restrict the menu offered by sidewalk carts -- Philadelphia and Pittsburgh being the exceptions -- convinced that poultry, for example, has no place on these units. ''As a public health professional, I have concerns about how they can handle all that,'' said Art Tilzer, of the Los Angeles County Department of Health Services, which confines vendors to food like pretzels and precooked hot dogs.

The price of variety can be food poisoning. In most cases, the symptoms are wrenching but short-lived; occasionally, however, the results are severe. Bacteria like E. coli O157:H7 can cause lifelong kidney damage and be deadly for children and the elderly. Salmonella, often found in raw chicken and eggs, accounts for 500 to 1,000 deaths a year nationally, and the more pervasive campylobacter bacterium, in chicken, is blamed for 500 deaths. While no such illnesses have been firmly traced back to street vendors in New York, experts like Dr. Michael Osterholm, chief epidemiologist for the State of Minnesota, say that is no cause for complacency.

''If I had a stand in New York City,'' he said, ''and I served 1,000 people and 200 became sick, and they left the city to go to their homes all over the metropolitan region, and the average incubation period was 24 to 48 hours, how often would I pick up that stand as being the source of the illness?''

The Offenders

Despite Violations, They Keep Cooking

On a bright spring day, Mohammad M. Ali was peddling sausage, hot dogs and shish kebab from a busy corner at Broadway and Canal Street. He was all New York, with his trademark umbrella and his savory-smelling food.

But for those who looked hard, Mr. Ali's stand showed signs of potential trouble -- his filthy towel, his bare hands on food, his technique of warming bread by setting it atop half-raw chicken kebabs on the grill.

When a health inspector showed up, Mr. Ali quickly pulled on a pair of soiled rubber gloves. As Mr. Ali looked on, the inspector checked his stand, warning him about his dirty rag, illegible permit decal and unheated water for washing. He was cited once, for not having a certificate showing he had passed the city's food-safety course.

''At my home,'' he said of the certificate. ''I'll bring tomorrow.'' But city records show that during five visits to Mr. Ali's pushcart in 1997, inspectors never found him with a safety certificate -- and that his need for training was abundantly clear.

In May 1997, Mr. Ali was cited for failing to have running water and soap to wash his hands; there were dead roaches in his cart and his shish kebabs were unchilled, at 75 degrees. Four months later, Mr. Ali lacked running water again. The next time, he was found storing raw beef on top of cooked beef.

In November, the list of violations was even longer: cooked chicken and sausage at 81 degrees, raw chicken at 60 degrees, no thermometer, no water and no soap.

Mr. Ali described the citations -- each of which carried a $100 fine -- as unfair. ''The restaurants, no checking,'' he said. ''The other people, no checking.'' After the inspector left, he took off his gloves and returned to cooking, his customers none the wiser.

Mr. Ali may not be the average food vendor in New York, but his problems illustrate a central deficiency in the city's system: chronic offenders are allowed to stay on the streets. During the last two fiscal years, just 15 to 20 carts have been shut down for food violations, and health officials acknowledge they have not made tracking repeat offenders a priority.

When food is found unchilled or unheated, inspectors ask how long it has been that way. If a vendor says less than two hours, inspectors generally order that the food quickly be heated or chilled, rather than discarded, records show. Last year, the city began to go after vendors who chronically violate cart placement regulations (too close to a fire hydrant or subway exit, for example). Chronic food-safety violators are next, said Ms. Lienhard, the assistant health commissioner.

The Inspectors

The City Struggles To Keep Track

When Atlanta prepared for the 1996 Summer Olympics, health officials there called their counterparts in New York, the mecca of street fare. How, they asked, did the city stay on top of these restaurants-on-wheels, with their difficult health issues?

New York's answer surprised them.

''They said they were overrun,'' said Janet Adams, program manager for the food service section of the Fulton County Health Department in Atlanta. ''They said they could not find the carts. They could not keep up with them.''

Comparing key provisions for regulating food carts, New York's system appeared looser and less effective, over all, than those in 10 major cities: Los Angeles, Chicago, Seattle, Pittsburgh, San Francisco, Denver, Washington, Minneapolis, Atlanta and Philadelphia. While allowing riskier fare than most cities, for example, New York officials often have little idea where the food carts are and how often each is being inspected on the street. Because vending spots are not assigned or permanent, some operators are nomadic, always looking for better locations. More than 800 times in 1996 and 1997 the city could not find a cart it went out to inspect, city records show.

''We're getting more and more aggressive about trying to find carts that are already in violation, but it's certainly an ongoing concern,'' Ms. Lienhard said.

Working neighborhood by neighborhood, city inspectors did about 2,300 spot checks of food carts in fiscal year 1996, 1,800 in 1997 and 2,600 so far in this fiscal year, which runs through next month. But some carts are inspected again and again, records show, while others elude the inspectors.

The Health Department's 90 inspectors are responsible not just for 4,100 food carts but also for 21,000 other operations like restaurants, day camps and swimming pools. Health officials said the number of inspectors in the field increased to 90 from 73 in the last five years, and Ms. Lienhard said she was confident that staffing was sufficient, adding that 10 inspectors would solely work a food-cart patrol for the summer season.

But in 1996 and 1997, even when the city received a complaint of illness, it typically took many weeks before an inspector checked out the cart in question, according to city records. A woman called the Health Department on Oct. 15, 1996, for example, to report becoming ill on chicken bought at a pushcart at 28th Street and Madison Avenue. But it was 10 weeks later, on Christmas Eve, when an inspector checked up and wrote: ''Chicken meat fresh. No spoil food observed. Food temperature good.''

A caller on Aug. 21, 1996, reported that a child had become sick after eating at a pushcart on 109th Street, between Amsterdam Avenue and Broadway. The summer heat became the winter cold before an inspector showed up -- on Jan. 6, 1997. No cart was there by then, or during subsequent inspections in March and May. The case was closed.

Ms. Lienhard acknowledged her department's slow response in the past, but she said it was doing much better now, with inspectors responding by the following week. But officials did not provide reports showing the change.

To educate vendors about food safety, the city requires a 15-hour course for those who cook on their carts. But many vendors do not go to class. Failing to show a safety certificate was second only to not having a permit as the most common violation during inspections, according to the 2,700 city reports.

Adding to the uncertainties are questions about where the street food comes from. By law, vendors must use licensed commercial food suppliers; the city asks for names when permits are issued. But the names are not checked, Ms. Lienhard acknowledged.

And unlike cities such as Seattle, Pittsburgh and San Francisco, New York does not insist that vendors use commissaries, the garagelike warehouses where street food is prepared and some carts are stored at night. (Other vendors store their carts in depots, and some take them home.)

Some commissaries have had safety problems of their own, but the city can at least inspect them and enforce its health standards. By contrast, some vendors talk of cooking at home, which is illegal and where the city does not inspect at all. ''They tend not to violate the law when they know they're being watched,'' Ms. Adams, in Atlanta, said of that region's vendors, who are required to use commissaries, stick to assigned spots and post the most recent inspection reports.

In most cities surveyed, carts are shut down if they lack essentials like running water. ''People know no place is perfect,'' said Jim Austin of the Denver Department of Environmental Health. ''But to go and find no water for something as basic as hand washing, that's unacceptable.''

The Solutions

How to Build Safety Into the System

National experts say there are a number of steps that could better insure the safety of New York's food carts.

Redesigning the carts themselves, with more reliable holding appliances for hot and cold foods, would be a big improvement, Dr. Gravani said. But just as important, he said, would be making the city's safety course a more practical education -- focusing on sidewalk cooking with limited equipment -- and tightening regulatory gaps.

''It would seem they need to tighten up on chronic violators and on enforcing food temperatures,'' he said, ticking off a list of other changes: more inspections, more follow-up, perhaps assigned vending spots or some form of menu limits. Another improvement would be requiring the use of commissaries, others suggested.

Still others recommended strict hand-washing rules -- with sinks mandatory on hot-dog and bagel carts as well as on carts offering fuller menus. ''If you saw some guy going to the bathroom or picking up trash or blowing his nose, would you want him buttering your bagel?'' asked Mr. Austin, the health official in Denver, where all carts that prepare food must have sinks.

In the end, Dr. Gravani said, the system needs revamping. ''Some people would argue it's only a gut ache, it's not that serious,'' he said. But on occasion, food poisoning is quite severe, he noted, adding, ''All of us deserve not to get sick from the food we eat.''

Fresh Hazards

Articles in this series have examined hazards in the American food supply. Earlier articles focused on the spread of harmful bacteria in fresh fruit juice and vegetables and concerns about raw oysters.